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Lamberti A, Falcinelli F, Cinotti E, Bruzziches F, Rubegni P, Cota C. Unilateral lichen planus pigmentosus inversus: Line-field confocal optical coherence tomography features and histopathological correlation. J Eur Acad Dermatol Venereol 2024. [PMID: 38454834 DOI: 10.1111/jdv.19914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/16/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Arianna Lamberti
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy
- Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Francesca Falcinelli
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy
| | - Elisa Cinotti
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy
| | - Francesco Bruzziches
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy
| | - Carlo Cota
- Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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Prete MD, Scarabello A, Lora V, Cota C. Stenotrophomonas maltophilia skin infection in an immunocompetent patient: Primary cutaneous CD30+ T-cell lymphoproliferative disorder or pseudolymphoma? J Cutan Pathol 2024. [PMID: 38419370 DOI: 10.1111/cup.14600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/29/2024] [Accepted: 02/02/2024] [Indexed: 03/02/2024]
Abstract
Cutaneous pseudolymphomas are a wide group of diseases mimicking cutaneous lymphoma. They comprise several skin conditions with different etiopathogenesis, clinical-pathological features, and prognosis, which may occur in the absence of an identifiable trigger factor or after administration of medications or vaccinations, tattoos, infections, or arthropod bites. They present with different manifestations: from solitary to regionally clustered lesions, up to generalized distribution and, in rare cases, erythroderma. They persist variably, from weeks to years, and resolve spontaneously or after antibiotics, but may recur in some cases. CD30+ T-cell pseudolymphomas are characterized by the presence of large, activated lymphoid cells, generally in response to viral infections, arthropod assault reactions, and drug eruptions. Stenotrophomonas maltophilia is a ubiquitous Gram-negative bacillus responsible for opportunistic infections in immunocompromised patients. Infection of intact skin in immunocompetent patients is particularly rare. Here, we report a case of a man presenting an isolated nodule histopathologically mimicking a primary cutaneous CD30+ T-cell lymphoproliferative disorder.
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Affiliation(s)
- Monia Di Prete
- Dermatopathology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | - Viviana Lora
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Carlo Cota
- Dermatopathology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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Cantisani C, Ambrosio L, Annessi E, Longo C, Farnetani F, Pezzini C, Condorelli A, Annessi G, Bonetti LR, Guida S, Cota C, Tammaro A, Chello C, Pellacani G. Dermoscopic, Histological, Confocal Microscopy Correlation of Atypical-Dysplastic Melanocytic Nevi. Dermatol Pract Concept 2024; 14:dpc.1401a36. [PMID: 38364391 PMCID: PMC10868881 DOI: 10.5826/dpc.1401a36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION The term "atypical melanocytic nevus" (AMN) is used as a synonym for dysplastic nevus (DN) in clinical practice. Although the criteria for diagnosis of AMN/DN by the Agency for Research on Cancer helps to differentiate AMN/DN from common acquired nevi, they do not have high degrees of specificity, as they are similar to those used for the diagnosis of melanoma. OBJECTIVES In this retrospective study we evaluated the correlation and diagnostic concordance of dermoscopy, confocal microscopy, and histological examination in 50 AMN. METHODS A graded scale was used to compare histological examination with dermoscopy and confocal microscopy. Low magnification histological images of only the central part of lesions were examined. This allowed histological diagnoses based almost exclusively on architectural criteria instead of simultaneously architectural and cytological, as in the global histological examination. RESULTS Our data demonstrate that the diagnostic accuracy of dermoscopy and confocal microscopy diagnosis of the clinical aspects of AMN/DN as nevi or melanomas tends to be equivalent, being fair for nevi and excellent for melanomas. The total percentage of AMN suggested that the accuracy of confocal microscopy in the diagnosis of melanoma (86.7%) is greater than that of dermoscopy (73.3%). CONCLUSIONS This study demonstrated that diagnostic assessments of AMN/DN by dermoscopy and confocal microscopy are accurate and often coincide with those of histological examination and that their combined use helps to better manage and monitor these patients by facilitating early detection of melanomas and reducing unnecessary excisions of benign melanocytic lesions.
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Affiliation(s)
- Carmen Cantisani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Luca Ambrosio
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Emanuele Annessi
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Caterina Longo
- Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Claudia Pezzini
- Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Giorgio Annessi
- Dermatopathology Unit, Istituto Dermopatico dell'Immacolata, IRCCS, Roma, Italy
| | - Luca Reggiani Bonetti
- Department of Diagnostic Clinic and Public Health Medicine University of Modena and Reggio Emilia, Italy
| | - Stefania Guida
- School of medicine Vita Salute San Raffaele University, Dermatology Clinic, IRCS San Raffaele Hospital, Milan, Italy
| | - Carlo Cota
- Genetic Research Molecular Biology and Dermopathology Unit San Gallicano Dermatology Unit, IRCCS, Rome Italy
| | - Antonella Tammaro
- NESMOS Dermatology Department, Sapienza University of Rome, Rome, Italy
| | - Camilla Chello
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
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Kovacs D, Flori E, Bastonini E, Mosca S, Migliano E, Cota C, Zaccarini M, Briganti S, Cardinali G. Targeting Fatty Acid Amide Hydrolase Counteracts the Epithelial-to-Mesenchymal Transition in Keratinocyte-Derived Tumors. Int J Mol Sci 2023; 24:17379. [PMID: 38139209 PMCID: PMC10743516 DOI: 10.3390/ijms242417379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
The endocannabinoid system regulates physiological processes, and the modulation of endogenous endocannabinoid (eCB) levels is an attractive tool to contrast the development of pathological skin conditions including cancers. Inhibiting FAAH (fatty acid amide hydrolase), the degradation enzyme of the endocannabinoid anandamide (AEA) leads to the increase in AEA levels, thus enhancing its biological effects. Here, we evaluated the anticancer property of the FAAH inhibitor URB597, investigating its potential to counteract epithelial-to-mesenchymal transition (EMT), a process crucially involved in tumor progression. The effects of the compound were determined in primary human keratinocytes, ex vivo skin explants, and the squamous carcinoma cell line A431. Our results demonstrate that URB597 is able to hinder the EMT process by downregulating mesenchymal markers and reducing migratory potential. These effects are associated with the dampening of the AKT/STAT3 signal pathways and reduced release of pro-inflammatory cytokines and tumorigenic lipid species. The ability of URB597 to contrast the EMT process provides insight into effective approaches that may also include the use of FAAH inhibitors for the treatment of skin cancers.
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Affiliation(s)
- Daniela Kovacs
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Enrica Flori
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Emanuela Bastonini
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Sarah Mosca
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Emilia Migliano
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy;
| | - Carlo Cota
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (C.C.); (M.Z.)
| | - Marco Zaccarini
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (C.C.); (M.Z.)
| | - Stefania Briganti
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Giorgia Cardinali
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
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Donà MG, Giuliani E, Giglio A, Pimpinelli F, Stingone C, Giuliani M, Alei L, Cota C, Iacovelli P, Frascione P, Latini A. Increasing trend in confirmed scabies cases in the only public dermatological institute of scientific research and care in Italy. Eur J Dermatol 2023; 33:709-710. [PMID: 38465564 DOI: 10.1684/ejd.2023.4622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Affiliation(s)
- Maria Gabriella Donà
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Eugenia Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Amalia Giglio
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Christof Stingone
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Lavinia Alei
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Carlo Cota
- Genetic Research Unit, Dermatological Molecular Biology and Dermatopathology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Paolo Iacovelli
- Clinical Dermatology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Pasquale Frascione
- Oncologic Dermatology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
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Orsini D, D'Arino A, Pigliacelli F, Iacovelli P, Pacifico A, Cota C, Di Prete M, Maramao FS. SARS-CoV-2: an environmental trigger of Darier's disease? J DERMATOL TREAT 2023; 34:2242541. [PMID: 37528796 DOI: 10.1080/09546634.2023.2242541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Affiliation(s)
- Diego Orsini
- Clinical Dermatology Unit, IFO-San Gallicano Dermatological Institute-IRCCS, 00144, Rome, Italy
| | - Andrea D'Arino
- Oncologic and Preventive Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Flavia Pigliacelli
- Clinical Dermatology Unit, IFO-San Gallicano Dermatological Institute-IRCCS, 00144, Rome, Italy
| | - Paolo Iacovelli
- Clinical Dermatology Unit, IFO-San Gallicano Dermatological Institute-IRCCS, 00144, Rome, Italy
| | - Alessia Pacifico
- Clinical Dermatology Unit, IFO-San Gallicano Dermatological Institute-IRCCS, 00144, Rome, Italy
| | - Carlo Cota
- Genetic Research Unit, Dermatological Molecular Biology and Dermatopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Monia Di Prete
- Genetic Research Unit, Dermatological Molecular Biology and Dermatopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Fabio Stefano Maramao
- Clinical and Research Resident, University of Rome Tor Vergata, Policlinico Tor Vergata, Rome, Italy
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Millan-Esteban D, García-Casado Z, Macià A, de la Rosa I, Torrecilla-Vall-Llossera C, Penin RM, Manrique-Silva E, Pellegrini S, Biasin MR, Rizzolo P, Gavillero A, Di Stefani A, Pellegrini C, Requena C, Fargnoli MC, Peris K, Cota C, Menin C, Landi MT, Nagore E. Molecular Profile of Subungual Melanoma: A MelaNostrum Consortium Study of 68 Cases Reporting BRAF, NRAS, KIT, and TERT Promoter Status. Dermatology 2023; 240:164-169. [PMID: 37918362 DOI: 10.1159/000534955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 08/31/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Subungual melanoma (SM) is an unusual type of melanocytic tumor affecting the nail apparatus. The mutational prevalence of the most prominently mutated genes in melanoma has been reported in small cohorts of SM, with unclear conclusions on whether SM is different from the rest of melanomas arising in acral locations or not. Hence, the molecular profile of a large series of SM is yet to be described. OBJECTIVES The aim of this study was to describe the molecular characteristics of a large series of SM and their association with demographic and histopathological features. METHODS Patients diagnosed with SM between 2001 and 2021 were identified from six Spanish and Italian healthcare centers. The mutational status for BRAF, NRAS, KIT, and the promoter region of TERT (TERTp) were determined either by Sanger sequencing or next-generation sequencing. Clinical data were retrieved from the hospital databases to elucidate potential associations. RESULTS A total of 68 SM cases were included. Mutations were most common in BRAF (10.3%) and KIT (10%), followed by NRAS (7.6%), and TERTp (3.8%). Their prevalence was similar to that of non-subungual acral melanoma but higher in SM located on the hand than on the foot. CONCLUSIONS To date, this study represents the largest cohort of SM patients with data on the known driver gene mutations. The low mutation rate supports a different etiopathogenic mechanism for SM in comparison of non-acral cutaneous melanoma, particularly for SM of the foot.
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Affiliation(s)
- David Millan-Esteban
- School of Medicine, Universidad Católica de València San Vicente Mártir, València, Spain
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain
| | - Zaida García-Casado
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, València, Spain
| | - Anna Macià
- Department of Experimental Medicine, Oncological Pathology Group, Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, Spain
| | - Inés de la Rosa
- Department of Experimental Medicine, Oncological Pathology Group, Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, Spain
| | | | - Rosa Maria Penin
- Department of Dermatology, Hospital Universitari de Bellvitge, Bellvitge, Spain
| | | | - Stefania Pellegrini
- Pathology Unit, Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Maria Raffaella Biasin
- Pathology Unit, Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Piera Rizzolo
- Department of Dermatopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Alicia Gavillero
- School of Medicine, Universidad Católica de València San Vicente Mártir, València, Spain
| | - Alessandro Di Stefani
- Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cristina Pellegrini
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Celia Requena
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- Dermatology Unit, Osppedale San Salvatore, L'Aquila, Italy
| | - Ketty Peris
- Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlo Cota
- Department of Dermatopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Chiara Menin
- Pathology Unit, Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Eduardo Nagore
- School of Medicine, Universidad Católica de València San Vicente Mártir, València, Spain
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain
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Bonadies A, Iorio A, Silipo V, Cota C, Govoni FA, Battista M, Pallara T, Migliano E. Bleomycin Electrochemotherapy of Dermal Cylindroma as an Alternative Treatment in a Rare Adnexal Neoplasm: A Case Report and Literature Review. Biomedicines 2023; 11:2667. [PMID: 37893041 PMCID: PMC10604352 DOI: 10.3390/biomedicines11102667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Brooke-Spiegler syndrome is a rare autosomal dominant disorder characterized by the continuous development of multiple benign skin appendage tumors. It is treated usually by repeated standard surgery. Here, we present a case study where electrochemotherapy (ECT) with bleomycin was used as an effective alternative approach in treating advanced dermal cylindromatosis of the head and neck in a patient with Brooke-Spiegler syndrome. PATIENTS AND METHODS A 45-year-old woman presented with multiple recurrent dermal cylindroma lesions on her scalp. Previous treatment consisted of several surgical excisions that resulted in psychological deterioration due to the formation of numerous scars and extensive alopecic areas. ECT was offered to provide tumor removal and disease control and to improve the patient's quality of life. RESULTS The treatment was well tolerated, and a significant reduction in neoplastic tissue was achieved. Importantly, scalp skin condition significantly improved, regaining a fair follicular density on the margins. CONCLUSION This report suggests the feasibility of bleomycin ECT as a less invasive alternative option for controlling multiple scalp cylindroma lesions with cosmetically acceptable results, and improving quality of life.
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Affiliation(s)
- Antonio Bonadies
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute—IRCCS, 00144 Rome, Italy; (T.P.); (E.M.)
| | - Alessandra Iorio
- Department of Oncologic and Preventative Dermatology, San Gallicano Dermatological Institute—IRCCS, 00144 Rome, Italy; (A.I.); (V.S.)
| | - Vitaliano Silipo
- Department of Oncologic and Preventative Dermatology, San Gallicano Dermatological Institute—IRCCS, 00144 Rome, Italy; (A.I.); (V.S.)
| | - Carlo Cota
- Dermatopathological Laboratory, San Gallicano Dermatological Institute—IRCCS, 00144 Rome, Italy;
| | - Flavio Andrea Govoni
- Department of Maxillofacial Surgery, ACO San Camillo, Forlanini, 00152 Rome, Italy;
| | - Michela Battista
- Scientific & Medical Department, IGEA S.p.A, 41012 Carpi, Italy;
| | - Tiziano Pallara
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute—IRCCS, 00144 Rome, Italy; (T.P.); (E.M.)
| | - Emilia Migliano
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute—IRCCS, 00144 Rome, Italy; (T.P.); (E.M.)
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Michor-Tscharre C, D’Alì L, Cota C, Fink-Puches R, Cerroni L. Clinical and Pathological Spectrum of Prurigo Pigmentosa in Central European Individuals. JAMA Dermatol 2023; 159:864-869. [PMID: 37436763 PMCID: PMC10339223 DOI: 10.1001/jamadermatol.2023.1917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/09/2023] [Indexed: 07/13/2023]
Abstract
Importance Based on early studies, prurigo pigmentosa (PP) was considered a rare inflammatory dermatosis affecting primarily Asian individuals. However, several case reports subsequently showed that the disease is not restricted to those of Asian origin. Large studies on PP in central European individuals, on the other hand, are missing. Objective To increase awareness of PP by describing the clinical, histopathological, and immunohistochemical features in central European individuals. Design, Setting, and Participants This observational, retrospective case series analyzed clinicopathological features of 20 central European patients diagnosed with PP. Data collection was performed by means of archive material, including physician's letters, clinical photographs, and histopathological records, at the Department of Dermatology at the Medical University of Graz in Austria from January 1998 to January 2022. Main Outcomes and Measures Demographic, clinical, histopathological, and immunohistochemical characteristics for patients diagnosed with PP were recorded. Results Of the 20 patients included, 15 (75%) were female, and the mean (range) age was 24.1 (15-51) years. The study cohort consisted entirely of European patients. The most common site of involvement of PP was the breast, followed by the neck and back. Other involved clinical sites were the abdomen, shoulders, face, head, axillae, arms, and genital region and groin. Clinically, lesions were characterized by a symmetric pattern in 90% (n = 18) of all cases. Marked hyperpigmentation was observed only in 25% (n = 5) of patients. In some cases, triggers such as malnutrition, long-term pressure, and friction were noted. Histologic findings revealed presence of neutrophils in all cases and necrotic keratinocytes in 67% (n = 16) of cases. Immunohistochemistry results showed predominance of CD8+ lymphocytes in the epidermis, as well as the presence of plasmacytoid dendritic cells and myeloid cell nuclear differentiation antigen-positive neutrophil precursors. Conclusions and Relevance This case series found that most clinical features observed in Asian patients were also observed in central European patients, but hyperpigmentation was primarily mild to moderate. Histopathological features were similar to those reported in the literature with the additional presence of myeloid cell nuclear differentiation antigen-positive precursor neutrophils. These results expand previous knowledge about PP in central European individuals.
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Affiliation(s)
| | - Lorenzo D’Alì
- Department of Pathology, University Hospital of Udine, Udine, Italy
| | - Carlo Cota
- Dermatopathology Unit, San Gallicano Dermatological Institute, Rome, Italy
| | | | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
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Alberti-Violetti S, Sapienza MR, Del Corvo M, Melle F, Motta G, Venegoni L, Cerroni L, Cota C, Pileri A, Berti E, Pileri SA. A Microenvironment-Related Nine-Gene Signature May Predict Survival in Mycosis Fungoides Patients at Diagnosis. Cells 2023; 12:1944. [PMID: 37566023 PMCID: PMC10417031 DOI: 10.3390/cells12151944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/03/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023] Open
Abstract
Mycosis fungoides (MF) is the most common cutaneous lymphoma characterized by an indolent course. Prognosis is stage-based but this approach does not reflect the different outcomes within stages. Considering that tumor microenvironment is known to be involved in MF pathogenesis and progression, we decided to investigate 99 MF cases by using the PanCancer Immune Profiling Panel. We identified and validated a signature of 9 genes able to predict MF survival and distinguish a high-risk group with a worse outcome from a low-risk group of cases with a better outcome. At the molecular level, low-risk vs. high-risk cases reported a global upregulation of immune genes, enriched in cytokines, and a higher density of dendritic cells and mast cells, possibly associated with a more favorable clinical course.
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Affiliation(s)
- Silvia Alberti-Violetti
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Maria Rosaria Sapienza
- Division of Diagnostic Haematopathology, European Institute of Oncology IRCCS, 20139 Milan, Italy; (M.R.S.); (M.D.C.); (F.M.); (G.M.); (S.A.P.)
| | - Marcello Del Corvo
- Division of Diagnostic Haematopathology, European Institute of Oncology IRCCS, 20139 Milan, Italy; (M.R.S.); (M.D.C.); (F.M.); (G.M.); (S.A.P.)
| | - Federica Melle
- Division of Diagnostic Haematopathology, European Institute of Oncology IRCCS, 20139 Milan, Italy; (M.R.S.); (M.D.C.); (F.M.); (G.M.); (S.A.P.)
| | - Giovanna Motta
- Division of Diagnostic Haematopathology, European Institute of Oncology IRCCS, 20139 Milan, Italy; (M.R.S.); (M.D.C.); (F.M.); (G.M.); (S.A.P.)
| | - Luigia Venegoni
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Lorenzo Cerroni
- Research Unit of Dermatopathology, Medical University of Graz, 8036 Graz, Austria;
| | - Carlo Cota
- Dermatopathology Laboratory San Gallicano, Dermatological Institute IRCCS, 00144 Rome, Italy;
| | - Alessandro Pileri
- Dermatology Unit, IRCCS AUBO, 40138 Bologna, Italy;
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
| | - Emilio Berti
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Stefano A. Pileri
- Division of Diagnostic Haematopathology, European Institute of Oncology IRCCS, 20139 Milan, Italy; (M.R.S.); (M.D.C.); (F.M.); (G.M.); (S.A.P.)
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11
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Giuliani E, Rollo F, Cota C, Gheit T, Galati L, McKay-Chopin S, Tedesco M, Migliano E, Benevolo M, Morrone A, Donà MG, Latini A. Alpha, Beta, and Gamma Human Papillomaviruses in Genital Lichen Sclerosus: A Retrospective Cross-Sectional Study. J Low Genit Tract Dis 2023; 27:236-241. [PMID: 37052458 DOI: 10.1097/lgt.0000000000000741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
BACKGROUND Lichen sclerosus (LS) is an inflammatory disease mostly arising at the genital level. It is unclear whether human papillomaviruses (HPVs) have an etiological significance in LS, and data on their prevalence in patients with LS are controversial. OBJECTIVES The authors assessed alpha, beta, and gamma HPV prevalence in patients with genital LS. The association of HPV positivity with demographic and clinical factors was also investigated. METHODS One hundred thirty-two formalin-fixed, paraffin-embedded LS samples (2016-2020) were retrieved from the archives of a pathology department. Alpha HPVs were genotyped with the INNO-LiPA HPV Genotyping Extra II kit. Beta and gamma HPVs were searched by multiplex Polymerase Chain Reaction. Immunostaining for p16 INK4a was performed on high-risk HPV-positive samples. RESULTS Patients had a median age of 61 years, were mostly women ( n = 73, 55.3%), and with an early disease stage ( n = 79, 59.8%). Alpha HPVs were detected in 12/132 cases (9.1%). Among the 5 high-risk HPV-positive cases, only 2 displayed a strong and diffuse p16 INK4a staining. Beta genus was the most prevalent (35/132, 26.5%) and HPV5 was the most frequent beta genotype (25/132, 18.9%). There were 3 gamma HPV-positive cases among those with a valid result (3/131, 2.3%). Multiple infections with genotypes belonging to different genera were infrequent (3/131, 2.3%). No significant differences in the prevalence of the individual genera were observed according to sex and disease stage. CONCLUSIONS Of the 3 HPV genera, beta genus showed the highest prevalence. Further research is needed to clarify whether the presence of beta HPVs in genital LS has a clinical significance.
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Affiliation(s)
- Eugenia Giuliani
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Francesca Rollo
- Pathology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Carlo Cota
- Genetic Research Unit, Dermatological Molecular Biology and Dermatopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Tarik Gheit
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Luisa Galati
- International Agency for Research on Cancer (IARC), Lyon, France
| | | | - Marinella Tedesco
- Plastic Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Emilia Migliano
- Plastic Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Maria Benevolo
- Pathology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Maria Gabriella Donà
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
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12
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Pallara T, Annovazzi A, Cristiani R, Vinci F, Bertozzi E, Bonadies A, Romani C, Tedesco M, Bellei B, Papaccio F, Caputo S, Cota C, Sperduti I, Govoni FA, Morrone A, Migliano E. Nonvisualized sentinel node on preoperative lymphoscintigraphy in primary cutaneous melanoma: an 11-year retrospective survey. Nucl Med Commun 2023; 44:345-350. [PMID: 36826418 DOI: 10.1097/mnm.0000000000001671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Sentinel lymph node (SLN) biopsy in cutaneous melanoma patients evaluates the regional draining basin for occult micrometastatic disease. Occasionally, nonidentification of SLN impairs the acquisition of this important prognostic factor. OBJECTIVES To investigate the outcomes of melanoma patients with negative lymphoscintigraphic findings and patients who underwent SLN biopsy from 2004 to 2015 ( n = 1200) were retrospectively reviewed for tumor characteristics and clinical outcomes. METHODS Patients with nonvisualized lymph nodes (NV group) who underwent only preoperative lymphoscintigraphy were separated and compared with a cohort drawn from all melanoma patients who completed the surgical procedure within the same period (V group). RESULTS A negative lymphoscintigraphic scan was observed in 38 cases (3.2% of all patients). The NV group showed a significantly older age (median 66.0 vs. 48.3 years; P < 0.0001). Head and neck melanomas were more frequent in the NV group compared to the control group (25.1 vs. 7.8%; P = 0.009). Tumor characteristics such as ulceration and Breslow thickness do not influence the lymphoscintigraphy result. No differences were found in overall survival (OS) and disease-free survival (DFS) between the groups. CONCLUSIONS The nonvisualization of regional lymph nodes by lymphoscintigraphy is more frequent in older patients with head and neck melanomas. From the clinical point of view, no specific recommendation emerged for patients' management because the nonvisualization of the SLN did not show a significant influence on DFS and OS rates. However, lack of knowledge of lymph node status suggests performing a tighter follow-up eventually by ultrasound evaluation of all potential lymph node drainage basins.
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Affiliation(s)
- Tiziano Pallara
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS
| | | | - Renzo Cristiani
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS
| | - Federica Vinci
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS
| | - Ettore Bertozzi
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS
| | - Antonio Bonadies
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS
| | - Claudia Romani
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS
| | - Marinella Tedesco
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS
| | - Barbara Bellei
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute IRCCS
| | - Federica Papaccio
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute IRCCS
| | - Silvia Caputo
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute IRCCS
| | - Carlo Cota
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute IRCCS
| | - Isabella Sperduti
- Biostatistical Unit - Clinical Trials Center Regina Elena National Cancer Institute
| | | | - Aldo Morrone
- Scientific Director, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Emilia Migliano
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute IRCCS
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13
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Flori E, Mosca S, Cardinali G, Briganti S, Ottaviani M, Kovacs D, Manni I, Truglio M, Mastrofrancesco A, Zaccarini M, Cota C, Piaggio G, Picardo M. The Activation of PPARγ by (2Z,4E,6E)-2-methoxyocta-2,4,6-trienoic Acid Counteracts the Epithelial–Mesenchymal Transition Process in Skin Carcinogenesis. Cells 2023; 12:cells12071007. [PMID: 37048080 PMCID: PMC10093137 DOI: 10.3390/cells12071007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the most common UV-induced keratinocyte-derived cancer, and its progression is characterized by the epithelial–mesenchymal transition (EMT) process. We previously demonstrated that PPARγ activation by 2,4,6-octatrienoic acid (Octa) prevents cutaneous UV damage. We investigated the possible role of the PPARγ activators Octa and the new compound (2Z,4E,6E)-2-methoxyocta-2,4,6-trienoic acid (A02) in targeting keratinocyte-derived skin cancer. Like Octa, A02 exerted a protective effect against UVB-induced oxidative stress and DNA damage in NHKs. In the squamous cell carcinoma A431 cells, A02 inhibited cell proliferation and increased differentiation markers’ expression. Moreover, Octa and even more A02 counteracted the TGF-β1-dependent increase in mesenchymal markers, intracellular ROS, the activation of EMT-related signal transduction pathways, and cells’ migratory capacity. Both compounds, especially A02, counterbalanced the TGF-β1-induced cell membrane lipid remodeling and the release of bioactive lipids involved in EMT. In vivo experiments on a murine model useful to study cell proliferation in adult animals showed the reduction of areas characterized by active cell proliferation in response to A02 topical treatment. In conclusion, targeting PPARγ may be useful for the prevention and treatment of keratinocyte-derived skin cancer.
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Affiliation(s)
- Enrica Flori
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
- Correspondence: (E.F.); (M.P.)
| | - Sarah Mosca
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Giorgia Cardinali
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Stefania Briganti
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Monica Ottaviani
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Daniela Kovacs
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Isabella Manni
- SAFU Unit, Department of Research, Diagnosis and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Roma, Italy
| | - Mauro Truglio
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Arianna Mastrofrancesco
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Marco Zaccarini
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Carlo Cota
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Giulia Piaggio
- SAFU Unit, Department of Research, Diagnosis and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Roma, Italy
| | - Mauro Picardo
- Faculty of Medicine, Unicamillus International Medical University, 00131 Rome, Italy
- Correspondence: (E.F.); (M.P.)
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14
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Ardigò M, Bianchi L, Cantisani C, Cota C, DI Raimondo C, DI Stefani A, Fargnoli MC, Franceschini C, Pellacani G, Peris K, Persechino S, Plebani S, Potenza C, Proietti I, Quattrini L, Cantonetti M. Mycosis fungoides: creation of a prospective, interdisciplinary and multicenter study in central Italy. Ital J Dermatol Venerol 2023; 158:156-157. [PMID: 36943388 DOI: 10.23736/s2784-8671.23.07377-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Affiliation(s)
- Marco Ardigò
- Porphyrias and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy -
| | - Luca Bianchi
- Dermatology, Tor Vergata University, Rome, Italy
| | | | - Carlo Cota
- Dermatopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | | | | | - Chiara Franceschini
- Porphyrias and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | - Ketty Peris
- Dermatology, Sacred Heart Catholic University, Rome, Italy
| | | | - Sara Plebani
- Hematology, San Salvatore Hospital, L'Aquila, Italy
| | | | - Ilaria Proietti
- Dermatology, Polo Pontino, Sapienza University, Latina, Italy
| | | | - Maria Cantonetti
- Lymphoproliferative Diseases Unit, Tor Vergata University, Rome, Italy
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15
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Donà MG, Gheit T, Chiantore MV, Vescio MF, Luzi F, Rollo F, Accardi L, Cota C, Galati L, Romeo G, Giuliani M, Tommasino M, Di Bonito P. Prevalence of 13 polyomaviruses in actinic keratosis and matched healthy skin samples of immunocompetent individuals. Infect Agent Cancer 2022; 17:59. [PMID: 36457033 PMCID: PMC9714215 DOI: 10.1186/s13027-022-00472-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Actinic keratosis (AK) is a precursor of cutaneous squamous cell carcinoma (cSCC). UV radiation is the major risk factor for AK, but certain human papillomaviruses (HPVs) of the beta genus are also involved in its development. Differently, the role of polyomaviruses (PyVs) in skin carcinogenesis is still debated. Fiftheen PyVs have been isolated from human tissues so far, including Merkel cell polyomavirus (MCPyV), the aetiological agent of Merkel cell carcinoma. METHODS The presence of 13 PyVs was assessed in skin samples from AK patients (n = 342). Matched fresh-frozen scrapings from healthy skin (HS) and AK lesions from 242 patients, and formalin-fixed paraffin-embedded AK biopsies from a different cohort of 100 patients were analyzed by multiplex PyVs genotyping assay. RESULTS The most frequent lesion site was the scalp in men (27.3%), and the cheek area in women (29.0%). Differences between men and women were significant for the scalp, the cheek area and the lips. Almost all the scrapings were PyV-positive (HS: 89.7%, AK: 94.6%; p = 0.04). The three most frequent PyVs were MCPyV, HPyV6 and JCPyV (HS: 87.2%, 58.7%, 6.6%, respectively; AK: 88.8%, 51.2%, 9.9%, respectively). HPyV9, TSPyV, BKPyV, HPyV7, LIPyV and SV40 were detected in < 2% of the scrapings. In most cases, matched HS and AK scrapings were both positive (MCPyV: 78.1%, HPyV6: 41.7%), or both negative for the individual genotypes (for the remaining PyVs). PyV prevalence in AK biopsies was 22.0%. Only MCPyV (21.0%) and HPyV6 (3.0%) were detected in these samples. CONCLUSIONS PyV prevalence in HS and AK scrapings was high, but detection of PyVs exclusively in AK scrapings was rare. PyV positivity rate in AK biopsies was modest. Further research is need to reach firm conclusions regarding the role of these viruses in AK development.
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Affiliation(s)
| | - Tarik Gheit
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Maria Fenicia Vescio
- Epidemiology Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Fabiola Luzi
- Plastic and Reconstructive Surgery, San Gallicano Dermatologic Institute IRCCS, Rome, Italy
| | - Francesca Rollo
- Pathology Department, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Luisa Accardi
- EVOR Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Cota
- Department of Dermopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Luisa Galati
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Giovanna Romeo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome-Polo Pontino, Latina, Italy
| | - Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | - Paola Di Bonito
- EVOR Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
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16
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Kovacs D, Bastonini E, Briganti S, Ottaviani M, D’Arino A, Truglio M, Sciuto L, Zaccarini M, Pacifico A, Cota C, Iacovelli P, Picardo M. Altered epidermal proliferation, differentiation, and lipid composition: Novel key elements in the vitiligo puzzle. Sci Adv 2022; 8:eabn9299. [PMID: 36054352 PMCID: PMC10848961 DOI: 10.1126/sciadv.abn9299] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Vitiligo is an acquired skin depigmentation disease involving multiple pathogenetic mechanisms, which ultimately direct cytotoxic CD8+ cells to destroy melanocytes. Abnormalities have been described in several cells even in pigmented skin as an expression of a functional inherited defect. Keratinocytes regulate skin homeostasis by the assembly of a proper skin barrier and releasing and responding to cytokines and growth factors. Alterations in epidermal proliferation, differentiation, and lipid composition as triggers for immune response activation in vitiligo have not yet been investigated. By applying cellular and lipidomic approaches, we revealed a deregulated keratinocyte differentiation with altered lipid composition, associated with impaired energy metabolism and increased glycolytic enzyme expression. Vitiligo keratinocytes secreted inflammatory mediators, which further increased following mild mechanical stress, thus evidencing immune activation. These findings identify intrinsic alterations of the nonlesional epidermis, which can be the prime instigator of the local inflammatory milieu that stimulates immune responses targeting melanocytes.
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Affiliation(s)
- Daniela Kovacs
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Emanuela Bastonini
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Stefania Briganti
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Monica Ottaviani
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Andrea D’Arino
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Mauro Truglio
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Lorenzo Sciuto
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Marco Zaccarini
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Alessia Pacifico
- Clinical Dermatology, Phototherapy Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Carlo Cota
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Paolo Iacovelli
- Clinical Dermatology, Phototherapy Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Mauro Picardo
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
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17
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Alberti-Violetti S, Del Corvo M, Melle F, Motta G, Sapienza MR, Venegoni L, Cerroni L, Cota C, Pileri A, Pileri S, Berti E. A 9-gene prognostic signature for predicting survival outcome in mycosis fungoides. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00565-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Falcinelli F, Lamberti A, Cota C, Rubegni P, Cinotti E. Reply to “Development of severe pemphigus vulgaris following
SARS‐CoV
‐2 vaccination with
BNT162b2
” by Solimani F et al. J Eur Acad Dermatol Venereol 2022; 36:e976-e978. [PMID: 35789506 PMCID: PMC9349510 DOI: 10.1111/jdv.18398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Francesca Falcinelli
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences Siena University Hospital Siena Italy
| | - Arianna Lamberti
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences Siena University Hospital Siena Italy
| | - Carlo Cota
- Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS Rome Italy
| | - Pietro Rubegni
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences Siena University Hospital Siena Italy
| | - Elisa Cinotti
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences Siena University Hospital Siena Italy
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19
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Lamberti A, Lora V, Graceffa D, Bonifati C, Cota C. Nail psoriasis: a rare mRNA COVID-19 vaccine reaction. J Eur Acad Dermatol Venereol 2022; 36:e745-e746. [PMID: 35604041 PMCID: PMC9348061 DOI: 10.1111/jdv.18255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/18/2022] [Indexed: 12/16/2022]
Affiliation(s)
- A. Lamberti
- Dermatopathology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly,Dermatology Unit, Department of Medical, Surgical and neurological SciencesUniversity of SienaSienaItaly
| | - V. Lora
- Dermatology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly
| | - D. Graceffa
- Dermatology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly
| | - C. Bonifati
- Dermatology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly
| | - C. Cota
- Dermatopathology UnitSan Gallicano Dermatological Institute, IRCCSRomeItaly
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20
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Del Bufalo D, Di Martile M, Valentini E, Manni I, Masi I, D'Amore A, Filippini A, Nicoletti C, Zaccarini M, Cota C, Castro MV, Quezada MJ, Rosanò L, Lopez-Bergami P, D'Aguanno S. Bcl-2-like protein-10 increases aggressive features of melanoma cells. Exploration of Targeted Anti-tumor Therapy 2022; 3:11-26. [PMID: 36046354 PMCID: PMC9400776 DOI: 10.37349/etat.2022.00068] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/20/2021] [Indexed: 11/29/2022] Open
Abstract
Aim: B-cell lymphoma-2 (Bcl-2)-like protein-10 (Bcl2L10) is the less studied
member of Bcl-2 family proteins, with the controversial role in different
cancer histotypes. Very recently, Bcl2L10 expression in melanoma tumor
specimens and its role in melanoma response to therapy have been
demonstrated. Here, the involvement of Bcl2L10 on the in
vitro and in vivo properties associated with
melanoma aggressive features has been investigated. Methods: Endogenous Bcl2L10 protein expression was detected by western blotting
analysis in a panel of patient-derived and commercially available human
melanoma cells. In vitro assays to evaluate clonogenicity,
cell proliferation, cell migration, cell invasion, and in
vitro capillary-like structure formation [vasculogenic
mimicry (VM)] have been performed by using human melanoma cells
stably overexpressing Bcl2L10 or transiently transfected for loss/gain
function of Bcl2L10, grown under two- or three-dimensional (3D) conditions
Xenograft melanoma model was employed to evaluate in vivo
tumor growth and angiogenesis. Results: Results demonstrated that Bcl2L10 acts as an inducer of in
vitro cell migration, invasion, and VM, while in
vitro cell proliferation, in vivo tumor
growth, as well as colony formation properties were not affected. Dissecting
different signaling pathways, it was found that Bcl2L10 positively affects
the phosphorylation of extracellular-signal-regulated kinase (ERK) and the
expression of markers of cell invasion, such as urokinase plasminogen
activator receptor (uPAR) and matrix metalloproteinases (MMPs). Of note,
Bcl2L10-dependent in vitro migration, invasion, and VM are
linked to uPAR. Bcl2L10 also negatively regulates the intracellular calcium
level. Finally, reduced invasion capability in 3D spheroid invasion assay of
melanoma cells transiently overexpressing Bcl2L10 was observed after
treatment with inhibitors of MMPs and uPAR. Conclusions: Overall, data reported in this paper provide evidence supporting a positive
role of Bcl2L10 in melanoma aggressive features.
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Affiliation(s)
- Donatella Del Bufalo
- Preclinical Models and New Therapeutic Agents Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Marta Di Martile
- Preclinical Models and New Therapeutic Agents Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Elisabetta Valentini
- Preclinical Models and New Therapeutic Agents Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Isabella Manni
- SAFU Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Ilenia Masi
- Institute of Molecular Biology and Pathology, National Research Council, 00161 Rome, Italy
| | - Antonella D'Amore
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University, 00161 Rome, Italy
| | - Antonio Filippini
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University, 00161 Rome, Italy
| | - Carmine Nicoletti
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University, 00161 Rome, Italy
| | - Marco Zaccarini
- Genetic Research, Dermatological Molecular Biology and Dermatopathology Unit, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy
| | - Carlo Cota
- Genetic Research, Dermatological Molecular Biology and Dermatopathology Unit, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy
| | - Maria Victoria Castro
- Centro de Estudios Biomédicos, Básicos, Aplicados y Desarrollo, Universidad Maimónides, Buenos Aires C1405BCK, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires C1405BCK, Argentina
| | - María Josefina Quezada
- Centro de Estudios Biomédicos, Básicos, Aplicados y Desarrollo, Universidad Maimónides, Buenos Aires C1405BCK, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires C1405BCK, Argentina
| | - Laura Rosanò
- Preclinical Models and New Therapeutic Agents Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; Institute of Molecular Biology and Pathology, National Research Council, 00161 Rome, Italy
| | - Pablo Lopez-Bergami
- Centro de Estudios Biomédicos, Básicos, Aplicados y Desarrollo, Universidad Maimónides, Buenos Aires C1405BCK, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires C1405BCK, Argentina
| | - Simona D'Aguanno
- Preclinical Models and New Therapeutic Agents Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
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21
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Papaccio F, Kovacs D, Bellei B, Caputo S, Migliano E, Cota C, Picardo M. Profiling Cancer-Associated Fibroblasts in Melanoma. Int J Mol Sci 2021; 22:7255. [PMID: 34298873 PMCID: PMC8306538 DOI: 10.3390/ijms22147255] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/18/2021] [Accepted: 06/25/2021] [Indexed: 11/18/2022] Open
Abstract
Solid tumors are complex systems characterized by dynamic interactions between neoplastic cells, non-tumoral cells, and extracellular components. Among all the stromal cells that populate tumor microenvironment, fibroblasts are the most abundant elements and are critically involved in disease progression. Cancer-associated fibroblasts (CAFs) have pleiotropic functions in tumor growth and extracellular matrix remodeling implicated in local invasion and distant metastasis. CAFs additionally participate in the inflammatory response of the tumor site by releasing a variety of chemokines and cytokines. It is becoming clear that understanding the dynamic, mutual melanoma-fibroblast relationship would enable treatment options to be amplified. To better characterize melanoma-associated fibroblasts, here we analyzed low-passage primary CAFs derived from advanced-stage primary skin melanomas, focusing on the immuno-phenotype. Furthermore, we assessed the expression of several CAF markers and the production of growth factors. To deepen the study of CAF-melanoma cell crosstalk, we employed CAF-derived supernatants and trans-well co-culture systems to evaluate the influences of CAFs on (i) the motogenic ability of melanoma cells, (ii) the chemotherapy-induced cytotoxicity, and (iii) the release of mediators active in modulating tumor growth and spread.
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Affiliation(s)
- Federica Papaccio
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (B.B.); (S.C.); (M.P.)
| | - Daniela Kovacs
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (B.B.); (S.C.); (M.P.)
| | - Barbara Bellei
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (B.B.); (S.C.); (M.P.)
| | - Silvia Caputo
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (B.B.); (S.C.); (M.P.)
| | - Emilia Migliano
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy;
| | - Carlo Cota
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy;
| | - Mauro Picardo
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (B.B.); (S.C.); (M.P.)
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22
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Grandi V, Baldo A, Berti E, Quaglino P, Rupoli S, Alaibac M, Alberti-Violetti S, Amerio P, Brazzelli V, Bruni PL, Calzavara-Pinton P, Parodi A, Cozzani E, Burlando M, Fargnoli MC, Gambini D, Iacovelli P, Pacifico A, Longo C, Monfrecola G, Motolese A, Mozzicafreddo G, Cota C, Pigatto P, Pileri A, Savoia P, Simonacci M, Venturini M, Offidani A, Molinelli E, Pellegrino M, Trovato E, Piccinno R, Lawrence K, Pimpinelli N. Italian expert-based recommendations on the use of photo(chemo)therapy in the management of mycosis fungoides: Results of an e-Delphi consensus. Photodermatol Photoimmunol Photomed 2021; 37:334-342. [PMID: 33458864 DOI: 10.1111/phpp.12658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/26/2020] [Accepted: 01/12/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Phototherapy is a mainstay for the treatment of MF. However, there is scarce evidence for its use, mostly due to the lack of a unified schedule. AIMS The primary aim of this study was to establish the first structured, expert-based consensus regarding the indications and technical schedules of NB-UVB and PUVA for MF. The secondary aim was to determine the consensus level for each specific item. MATERIALS & METHODS E-delphi study. Item-specific expert consensus was defined as the number of "Totally Agree" results to ≥80% of the panelists. Cronbach alpha index ≥0.7 was used as a measure of homogeneity in the responses among questions related to the same topic. RESULTS Overall, there was a high homogeneity among responders (0.78). On specific topics, the highest grade was observed for technical items (0.8) followed by indications for early (0.73) and advanced stages (0.7). CONCLUSIONS Items related to the most canonical indications of phototherapy and to treatment schedules showed the highest agreements rates. There is consensus about the use of standardized treatment schedules for the induction and consolidation phases for NB-UVB and PUVA in MF.
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Affiliation(s)
- Vieri Grandi
- Dip. Scienze della Salute, sezione Dermatologia, Universita' degli Studi di Firenze, Firenze, Italy.,St John's Institute of Dermatology, GSTT NHS Foundation Trust, London, UK
| | - Antonello Baldo
- Clinica Dermatologica Azienda Ospedaliera Universitaria Federico II, Napoli, Italy
| | - Emilio Berti
- Dipartimento di Medicina Interna, UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Dipartimento di Medicina, Fisiopatologia medico-chirurgica e dei trapianti, Università degli Studi di Milano, Milano, Italy
| | - Pietro Quaglino
- Clinica Dermatologica AOU Città della Salute e della Scienza, Università degli Studi di Torino, Torino, Italy
| | - Serena Rupoli
- SOD Clinica Ematologica, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Mauro Alaibac
- Clinica Dermatologica, Università degli Studi di Padova, Padova, Italy
| | - Silvia Alberti-Violetti
- Dipartimento di Medicina Interna, UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Dipartimento di Medicina, Fisiopatologia medico-chirurgica e dei trapianti, Università degli Studi di Milano, Milano, Italy
| | - Paolo Amerio
- Clinica Dermatologica Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Valeria Brazzelli
- Clinica Dermatologica, Fondazione Policlinico San Matteo IRCCS, Pavia, Italy
| | - Pier Luigi Bruni
- Struttura Complessa di Clinica Dermatologica, Azienda Ospedaliera S. Maria, Terni, Italy
| | | | - Aurora Parodi
- Clinica Dermatologia, DISSAL, Ospedale Policlinico IRCSS San Martino, Genova, Italy
| | - Emanuele Cozzani
- Clinica Dermatologia, DISSAL, Ospedale Policlinico IRCSS San Martino, Genova, Italy
| | - Martina Burlando
- Clinica Dermatologia, DISSAL, Ospedale Policlinico IRCSS San Martino, Genova, Italy
| | - Maria Concetta Fargnoli
- UOSD di Dermatologia Generale ed Oncologica, Ospedale San Salvatore, e Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli Studi dell'Aquila, L'Aquila, Italy
| | | | | | | | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | | | - Alberico Motolese
- S.C. Dermatologia, Azienda USL di Reggio Emilia - IRCCS, Presidio Ospedaliero Provinciale Santa Maria Nuova, Reggio Emilia, Italy
| | | | - Carlo Cota
- UO Dermatologia, INRCA-IRCSS, Ancona, Italy
| | - Paolo Pigatto
- Dermatologia, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Alessandro Pileri
- UO Dermatologia, Dipartimento di Medicina Specialistica Diagnostica e Sperimentale (DIMES), Università degli Studi di Bologna, Bologna, Italy
| | - Paola Savoia
- Dipartimento di Scienze della Salute, Università del Piemonte Orientale, Novara, Italy
| | - Marco Simonacci
- Unità Operativa Dermatologia, Ospedale di Macerata, Macerata, Italy
| | - Marina Venturini
- Clinica Dermatologica Università di Brescia e U.O. Dermatologia, ASST Spedali Civili, Brescia, Italy
| | - Annamaria Offidani
- SOD Clinica di Dermatologia, Azienza Ospedaliero Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Elisa Molinelli
- SOD Clinica di Dermatologia, Azienza Ospedaliero Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | | | - Emanuele Trovato
- Dermatologia, Ospedale Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Roberta Piccinno
- Sezione Fotoradioterapia, UOC Dermatologia, Dipartimento di Medicina Interna e Specialità Mediche, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Karl Lawrence
- St John's Institute of Dermatology, Faculty of Life Sciences and Medicine, King's College of London, London, UK
| | - Nicola Pimpinelli
- Dip. Scienze della Salute, sezione Dermatologia, Universita' degli Studi di Firenze, Firenze, Italy
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23
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Carboni F, Covello R, Cota C, Valle M. Unusual presentation of metastatic radiogenic breast angiosarcoma. Jpn J Clin Oncol 2021; 51:1339-1340. [PMID: 34105728 DOI: 10.1093/jjco/hyab088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Fabio Carboni
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Renato Covello
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Carlo Cota
- Dermopathology Unit, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Mario Valle
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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24
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Orsini D, D'Arino A, Tedesco M, Cota C, Pigliacelli F, Assorgi C, Latini A, Cristaudo A, Morrone A. Facial Abrikosoff tumour: The role of the dermatologist during COVID‐19 pandemic. Int Wound J 2020; 17:2026-2027. [PMID: 32573933 PMCID: PMC7361726 DOI: 10.1111/iwj.13431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Diego Orsini
- San Gallicano Dermatological Institute IRCCS Rome Italy
| | | | | | - Carlo Cota
- Dermatology Unit IRCCS INRCA Ancona Italy
| | | | | | | | | | - Aldo Morrone
- San Gallicano Dermatological Institute IRCCS Rome Italy
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25
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Laribi K, Baugier de Materre A, Sobh M, Cerroni L, Valentini CG, Aoki T, Suzuki R, Takeuchi K, Frankel AE, Cota C, Ghez D, Le Calloch R, Pagano L, Petrella T. Blastic plasmacytoid dendritic cell neoplasms: results of an international survey on 398 adult patients. Blood Adv 2020; 4:4838-4848. [PMID: 33027528 PMCID: PMC7556130 DOI: 10.1182/bloodadvances.2020002474] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study is to describe the clinical and prognostic features and to evaluate the outcome of different therapeutic approaches among patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN) who have been diagnosed and treated in different institutions. A total of 398 patients from 75 centers were included in the study. Treatment consisted of non-Hodgkin lymphoma (NHL)-like regimens in 129 (32.8%) patients and acute leukemia (AL)-like regimens in 113 (23.5%) patients. In 61 (15.5%) and 16 (4.1%) patients, chemotherapy was followed by allogeneic and autologous hematopoietic stem cell transplantation (HSCT), respectively. Twenty-seven (6.9%) patients received radiotherapy, 6 (1.5%) received new agents, and 62 (15.7%) received palliative care. After a median follow-up of 12 months, median overall survival (OS) was 18 months. Patients who received NHL/AL-like regimens, followed by allogeneic HSCT, had the best outcome; median OS was not reached. OS was 65 months for patients who underwent autologous HSCT; 18 months and 14 months, respectively, for those treated with AL-like and NHL-like regimens without consolidation; and 4 months for those receiving palliative care (P < .001). In BPDCN, chemotherapy with lymphoma- or AL-like regimens, followed by transplantation, represents the therapeutic strategy associated with the best outcome. Consolidation with allogeneic HSCT, when feasible, appears superior to autologous HSCT.
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Affiliation(s)
- Kamel Laribi
- Department of Hematology, Centre Hospitalier Le Mans, Le Mans, France
| | | | - Mohamad Sobh
- Hematology, BMT Program, The Ottawa Hospital, Ottawa, ON, Canada
| | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | - Tomohiro Aoki
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ritsuro Suzuki
- Department of Oncology/Hematology, Shimane University Hospital, Izumo, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets and Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Arthur E Frankel
- University of South Alabama Mitchell Cancer Institute, Mobile, AL
| | - Carlo Cota
- Department of Dermatology, IRCCS INRCA, Ancona, Italy
| | - David Ghez
- Department of Hematology, Institut Gustave Roussy, Villejuif, France
| | - Ronan Le Calloch
- Service de Médecine Interne-Maladies du Sang-Maladies Infectieuses, Centre Hospitalier de Cornouaille, Quimper, France; and
| | - Livio Pagano
- Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Tony Petrella
- Department of Pathology, University of Montréal, Hospital Maisonneuve-Rosemont, Montreal, QC, Canada
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26
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Tedesco M, Bellei B, Garelli V, Caputo S, Latini A, Giuliani M, Cota C, Chichierchia G, Romani C, Foddai ML, Cristaudo A, Morrone A, Migliano E. Adipose tissue stromal vascular fraction and adipose tissue stromal vascular fraction plus platelet-rich plasma grafting: New regenerative perspectives in genital lichen sclerosus. Dermatol Ther 2020; 33:e14277. [PMID: 32888384 DOI: 10.1111/dth.14277] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/03/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022]
Abstract
Lichen sclerosus (LS) is a chronic relapsing, inflammatory skin disorder usually involving the anogenital region of both sexes lacking a resolutive therapy. This study compared adipose tissue derived-stromal vascular fraction (AD-SVF) and AD-SVF-enriched platelet-rich plasma (PRP) therapy in the management of genital LS patients. Additionally, in vitro evaluation of cells and growth factors contained in the injected SVF has been evaluated as possible predictive factors for treatment outcome. The study population was 40 patients diagnosed with LS who were symptomatic despite medical treatment. Patients (age 43-78 years) randomized into two groups using a 1:1 allocation ratio, were evaluated clinically and assessing dermatology life quality index (DLQI) before and 6 months after treatment. Both procedures demonstrated a strong safety profile with no complications linked to the therapy. After 6 months, both treatments allowed for a significant improvement respect to baseline. Combinatory therapy demonstrated decreased efficacy in late stage patients. No correlations have been found between clinical and biological findings. AD-SVF and AD-SVF plus PRP are safe and effective regenerative approaches for genital LS patients. Clinical results support the preferential use of combinatory therapy for early stage patients confirming a synergic effect of AD-SVF and PRP. In contrast, AD-SVF plus PRP is discouraged for late stage patients.
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Affiliation(s)
- Marinella Tedesco
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Barbara Bellei
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Valentina Garelli
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Silvia Caputo
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Alessandra Latini
- Lichen Sclerosus Unit, Department of Dermatology STI, Environmental Health, Tropical and Immigration, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Massimo Giuliani
- Lichen Sclerosus Unit, Department of Dermatology STI, Environmental Health, Tropical and Immigration, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Carlo Cota
- Department of Dermatology, IRCCS INRCA, Ancona, Italy.,Dermophatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Giuseppina Chichierchia
- Immunohaematology and Trasfusion Medicine, IRCCS Regina Elena National Cancer Institute, Rome, Italy.,Musculo-Skeletal Tissue Bank, IRCCS Regina Elena National Cancer Institute, Rome, Lazio, Italy
| | - Claudia Romani
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Maria Laura Foddai
- Immunohaematology and Trasfusion Medicine, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonio Cristaudo
- Lichen Sclerosus Unit, Department of Dermatology STI, Environmental Health, Tropical and Immigration, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Aldo Morrone
- Scientific Director San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Emilia Migliano
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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27
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Molinelli E, Brisigotti V, Simonetti O, Campanati A, Sapigni C, D'Agostino GM, Giacchetti A, Cota C, Offidani A. Efficacy and safety of topical resorcinol 15% as long-term treatment of mild-to-moderate hidradenitis suppurativa: a valid alternative to clindamycin in the panorama of antibiotic resistance. Br J Dermatol 2020; 183:1117-1119. [PMID: 32579711 DOI: 10.1111/bjd.19337] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 12/15/2022]
Affiliation(s)
- E Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - V Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - O Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - A Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - C Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - G M D'Agostino
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - A Giacchetti
- Dermatological Unit, Institute for Treatment and Research INRCA IRCCS, Ancona, Italy
| | - C Cota
- Dermatological Unit, Institute for Treatment and Research INRCA IRCCS, Ancona, Italy
| | - A Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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28
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Kovacs D, Bastonini E, Iacovelli P, Pacifico A, Cota C, Picardo M. 688 Keratinocyte behaviour in normal appearing vitiligo skin. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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29
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Persechino F, Franceschini C, Iorio A, Carbone A, Ferrari A, Buccini P, Piemonte P, Eibenschutz L, Sperduti I, Cota C, Frascione P, Ardigo M. Clinical management of very small pigmented lesions: Improved clinical outcome through dermoscopy and reflectance confocal microscopy combination. Skin Res Technol 2020; 26:718-726. [PMID: 32207544 DOI: 10.1111/srt.12863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 02/29/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Small-sized pigmented lesions (SSPL) <3 mm in diameter are common pitfall in the daily dermatology practice. Dermoscopy alone is hampered by the lack of specific features inversely proportional to the diameter of the lesions and its performance is highly operator-dependent. Reflectance confocal microscopy (RCM) has been demonstrated to be effective in the diagnosis of several difficult lesions where dermoscopy lacks to provide conclusive information. MATERIALS AND METHODS A total of 179 lesions with uncertain or equivocal clinical and dermoscopy appearance were selected. Dermoscopist has been requested to express a diagnostic suspect when possible. Equivocal lesions underwent RCM performed by expert for second-level evaluation before surgical excision for histological diagnosis. Results have been later statistically analysed. RESULTS Dermoscopy was not diagnostic in large number of lesions with low concordance histology (39.1%) instead of a much high concordance when combined with RCM (93.9%). CONCLUSIONS Small-sized pigmented lesions were more likely to be located on the face area. Diagnosis of pigmented BCC was relatively easy on dermoscopy and also in the case of small lesions showing typical signs of BCC. LM and MM have been seen to be particularly difficult to be diagnosed using only dermoscopy. The combination of digital dermoscopy and RCM represents the correct approach of SSPL.
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Affiliation(s)
- Flavia Persechino
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Clinical Dermatology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Chiara Franceschini
- Clinical Dermatology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Alessandra Iorio
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Anna Carbone
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Angela Ferrari
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Pierluigi Buccini
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Paolo Piemonte
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Laura Eibenschutz
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Isabella Sperduti
- Biostatistical Unit, Scientific Direction, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Carlo Cota
- Dermatopathology Laboratory, San Gallicano Dermatological Institute, Rome, Italy
| | - Pasquale Frascione
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Marco Ardigo
- Clinical Dermatology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
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30
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Biondo G, Cerroni L, Brunasso AMG, Sola S, Cota C, Javor S, Massone C. Risk of mycosis fungoides in psoriatic patients: a critical review. J Eur Acad Dermatol Venereol 2020; 34:1186-1195. [PMID: 31856345 DOI: 10.1111/jdv.16160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/26/2019] [Indexed: 12/18/2022]
Abstract
Psoriasis has been controversially associated with risk of non-Hodgkin lymphoma (NHL) and mycosis fungoides (MF). Also patients who developed MF after systemic treatment for psoriasis have been reported, and some authors suggested that the association between MF and psoriasis is not infrequent. We performed an extensive literature review in order to examine the risk of developing MF in psoriatic patients with a systematic search of the English-language databases. An increased risk for lymphoma overall in psoriatic patients has been found only by three out of seven studies. The risk of developing MF in psoriatic patients has been investigated by different studies in different populations and with different methodologies presenting bias and limitations, and it seems reasonable that misclassification between psoriasis and MF may explain the association reported. In contrast to the large number of psoriatic patients treated with biologicals, only 27 case reports of MF after biological therapy for psoriasis have been reported, and in 10 cases, the initial psoriasis diagnoses were then revised as MF. A true association between MF and psoriasis is possible, but the real incidence and prevalence are still unknown. The reported higher risk of developing MF in psoriatic patients should be reconsidered in the light of the bias of misclassification and the low magnitude reported in previous studies. There is not enough evidence to support a causal relation among biological therapies and MF in psoriatic patients.
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Affiliation(s)
- G Biondo
- Dermatology Unit, Galliera Hospital, Genoa, Italy
| | - L Cerroni
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | - S Sola
- Surgical Pathology, Galliera Hospital, Genoa, Italy
| | - C Cota
- Dermatology Unit, IRCCS INRCA, Ancona, Italy
| | - S Javor
- Dermatology Unit, Galliera Hospital, Genoa, Italy
| | - C Massone
- Dermatology Unit, Galliera Hospital, Genoa, Italy
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31
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Saggini A, Cota C. Local invasion in endocrine mucin-producing sweat gland carcinoma: Still an open issue. J Cutan Pathol 2019; 47:192-194. [PMID: 31755569 DOI: 10.1111/cup.13616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/10/2019] [Accepted: 11/18/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Andrea Saggini
- Anatomic Pathology-Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Cota
- Department of Dermatology, IRCCS INRCA, Ancona, Italy
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32
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Morrone A, Scarabello A, Sperduti I, Cota C, Donà MG, Orsini D, Cristaudo A. Donovanosis in migrants: a clinical case series in an Italian dermatological hospital. J Eur Acad Dermatol Venereol 2019; 33:e438-e440. [PMID: 31313396 DOI: 10.1111/jdv.15809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/17/2019] [Accepted: 06/21/2019] [Indexed: 12/01/2022]
Affiliation(s)
- A Morrone
- Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - A Scarabello
- Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - I Sperduti
- Department of Bio-Statistics, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - C Cota
- Department of Dermopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy.,Dermatology Unit, IRCCS INRCA, Ancona, Italy
| | - M G Donà
- Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - D Orsini
- Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - A Cristaudo
- Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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33
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Saggini A, Cerroni L, Casini B, Baciorri F, Cota C. Primary intrafascial desmoplastic melanoma with pseudoglandular differentiation and aberrant cytokeratins expression: An exceptional presentation. Pathol Res Pract 2019; 215:152668. [DOI: 10.1016/j.prp.2019.152668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022]
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34
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Carbone A, Persechino F, Paolino G, Cota C, Piemonte P, Franceschini C, Eibenschutz L, Ferrari A, Buccini P, Frascione P, Calvieri S, Ardigò M. Enlarging melanocytic lesions with peripheral globular pattern: a dermoscopic and confocal microscopy study. Ital J Dermatol Venerol 2019. [PMID: 31760729 DOI: 10.23736/s0392-0488.19.06471-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Enlarging melanocytic lesions with peripheral globular pattern (EMLPGP) are a pitfall in dermoscopy. Our aim was to evaluate the meaning of EMLPGP and to assess the use of dermoscopy and reflectance confocal microscopy (RCM) in order to improve the clinical management of this subtype of melanocytic lesions. METHODS A total of 135 EMLPGP were recruited and, accordingly to the dermoscopy features, were removed; later, an expert dermoscopist reviewed the lesions blinded to histology. Moreover, a subgroup of 63 lesions who underwent also to RCM, were reviewed by an expert confocalist. RESULTS Patients had a median age of 41 years old and a female prevalence (61.5%). The main anatomic site was the trunk (86%). Histology of the 135 excised EMLPGP disclosed 116 nevi (86%; P<0.0001) and 19 melanomas (14%). On dermoscopy, statistical significance was detected for small globules that were observed in 106 cases (78.5%; P<0.0001), while globules distribution and color did not impact the diagnosis prediction, as well as age, sex or any other patient profile. Considering the RCM, atypical cytology and irregular architecture were detected in 100% of melanomas (P<0.0001). CONCLUSIONS Our study shows that EMLPGPs are detectable in every age and can be a pitfall in especially in high risk patients with an over-excision of lesions. The presence of peripheral globules should be evaluated considering the overall dermoscopic features. RCM can contribute significantly in the management of lesions trough the detection of cyto-architectural atypia. Therefore, RCM in combination with dermoscopy can optimize the reduction of harmless lesions.
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Affiliation(s)
- Anna Carbone
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy -
| | - Flavia Persechino
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Giovanni Paolino
- Department of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy.,Dermatology Clinic, Sapienza University, Rome, Italy
| | - Carlo Cota
- Dermatopathology Research Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Paolo Piemonte
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Chiara Franceschini
- Rare Disease Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Laura Eibenschutz
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Angela Ferrari
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pierluigi Buccini
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pasquale Frascione
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | | | - Marco Ardigò
- Rare Disease Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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35
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Carbone A, Persechino F, Paolino G, Cota C, Piemonte P, Franceschini C, Eibenschutz L, Ferrari A, Buccini P, Frascione P, Calvieri S, Ardigò M. Enlarging melanocytic lesions with peripheral globular pattern: a dermoscopic and confocal microscopy study. Ital J Dermatol Venerol 2019; 156:467-472. [PMID: 31760729 DOI: 10.23736/s2784-8671.19.06471-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Enlarging melanocytic lesions with peripheral globular pattern (EMLPGP) are a pitfall in dermoscopy. Our aim was to evaluate the meaning of EMLPGP and to assess the use of dermoscopy and reflectance confocal microscopy (RCM) in order to improve the clinical management of this subtype of melanocytic lesions. METHODS A total of 135 EMLPGP were recruited and, accordingly to the dermoscopy features, were removed; later, an expert dermoscopist reviewed the lesions blinded to histology. Moreover, a subgroup of 63 lesions who underwent also to RCM, were reviewed by an expert confocalist. RESULTS Patients had a median age of 41 years old and a female prevalence (61.5%). The main anatomic site was the trunk (86%). Histology of the 135 excised EMLPGP disclosed 116 nevi (86%; P<0.0001) and 19 melanomas (14%). On dermoscopy, statistical significance was detected for small globules that were observed in 106 cases (78.5%; P<0.0001), while globules distribution and color did not impact the diagnosis prediction, as well as age, sex or any other patient profile. Considering the RCM, atypical cytology and irregular architecture were detected in 100% of melanomas (P<0.0001). CONCLUSIONS Our study shows that EMLPGPs are detectable in every age and can be a pitfall in especially in high risk patients with an over-excision of lesions. The presence of peripheral globules should be evaluated considering the overall dermoscopic features. RCM can contribute significantly in the management of lesions trough the detection of cyto-architectural atypia. Therefore, RCM in combination with dermoscopy can optimize the reduction of harmless lesions.
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Affiliation(s)
- Anna Carbone
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy -
| | - Flavia Persechino
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Giovanni Paolino
- Department of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy.,Dermatology Clinic, Sapienza University, Rome, Italy
| | - Carlo Cota
- Dermatopathology Research Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Paolo Piemonte
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Chiara Franceschini
- Rare Disease Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Laura Eibenschutz
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Angela Ferrari
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pierluigi Buccini
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pasquale Frascione
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | | | - Marco Ardigò
- Rare Disease Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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Solivetti FM, Desiderio F, Elia F, Guerrisi A, Cota C, Morrone A. Sonographic appearance of sebaceous cysts. Our experience and a review of the literature. Int J Dermatol 2019; 58:1353-1359. [PMID: 31209860 DOI: 10.1111/ijd.14515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/07/2019] [Accepted: 05/13/2019] [Indexed: 11/26/2022]
Abstract
Sebaceous cysts are benign enveloped nodules resulting from an obstruction of a hair follicle. Although they are very common, differential diagnosis is not obvious and may include many diseases. Ultrasound examination with high frequency probes, in the hands of a skilled operator, is the gold standard for noninvasive evaluation of these diseases. The aim of our study was to describe sonographic patterns found in our experience with high frequency probes. We decided to reevaluate the sonographic appearance of the last 100 patients with sebaceous cysts that were under our observation through conducting a retrospective study. All lesions were examined by a skilled radiologist with an Esaote MyLab 70 XVG ultrasound unit and a dedicated 18 MHz linear probe, sometimes supplemented by 20 MHz. In these skin lesions, we evaluated morphology, size, vascularity, and especially the visibility of skin pores, a characteristic of sebaceous cysts. We found 118 lesions that were mostly located on the trunk. In the majority of cases, the skin lesions had an oval-shaped morphology - 114 (96.6%) - and were hypoechoic in appearance -108 (91.5%). In 60 (50.8%) cases, the skin lesions showed a homogeneous appearance, known as "pseudotestis". The average ultrasound examines with very high frequency probes allowed to evidence skin pores. Our retrospective study on higher frequency probes confirms the data in literature regarding the diagnosis of sebaceous cysts, demonstrating the high incidence and clinical significance of evidence of the so-called epidermal punctum.
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Affiliation(s)
| | - Flora Desiderio
- Radiodiagnostic Service San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Fulvia Elia
- Radiodiagnostic Service San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Antonino Guerrisi
- Radiodiagnostic Service San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Carlo Cota
- Dermatopathology Laboratory San Gallicano, Dermatological Institute IRCCS, Rome, Italy
| | - Aldo Morrone
- Scientific Director San Gallicano Dermatological Institute IRCCS, Rome, Italy
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37
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Fabel A, Giovanna Brunasso AM, Schettini AP, Cota C, Puntoni M, Nunzi E, Biondo G, Cerroni L, Massone C. Pathogenesis of Leprosy: An Insight Into B Lymphocytes and Plasma Cells. Am J Dermatopathol 2019; 41:422-427. [DOI: 10.1097/dad.0000000000001310] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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38
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Saggini A, Cota C, Lora V, Kutzner H, Rütten A, Sangüeza O, Requena L, Cerroni L. Uncommon Histopathological Variants of Malignant Melanoma. Part 2. Am J Dermatopathol 2019; 41:321-342. [PMID: 31009411 DOI: 10.1097/dad.0000000000001226] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Despite new horizons opened by recent advances in molecular pathology, histological evaluation still remains the diagnostic gold standard regarding cutaneous melanocytic neoplasms. Several histological variants of melanoma have been described, and their knowledge is crucial for accurate diagnosis and classification of cases with unusual clinico-pathological features. Uncommon histological variants of melanoma have been described based on a broad constellation of features, including architectural pattern, stromal alterations, cytological attributes, and other morphological properties. This review is aimed at providing an extensive discussion of unusual but distinctive histopathological variants of melanoma.
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Affiliation(s)
- Andrea Saggini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Cota
- San Gallicano Dermatological Institute, Rome, Italy
| | - Viviana Lora
- San Gallicano Dermatological Institute, Rome, Italy
| | - Heinz Kutzner
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Arno Rütten
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Omar Sangüeza
- Department of Pathology, Wake Forest School of Medicine, Winston Salem, NC
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Lorenzo Cerroni
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
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39
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Ventura A, Pitocco R, Di Stefani A, Cota C, Spallone D, Bianchi L, Spallone G. Image Gallery: Peculiar subungual localization of a second primary melanoma during BRAF inhibitors treatment for metastatic melanoma: case report. Br J Dermatol 2019; 180:e142. [PMID: 31025747 DOI: 10.1111/bjd.17539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Ventura
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - R Pitocco
- Unit of Dermatology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Di Stefani
- Division of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - C Cota
- Department of Dermatopathology, San Gallicano Dermatological Institute, Via Elio Chianesi 53, Rome, 00144, Italy
| | - D Spallone
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy.,Department of Plastic Surgery, San Giovanni Hospital
| | - L Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - G Spallone
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
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40
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Cota C, Saggini A, Lora V, Kutzner H, Rütten A, Sangüeza O, Requena L, Cerroni L. Uncommon Histopathological Variants of Malignant Melanoma: Part 1. Am J Dermatopathol 2019; 41:243-263. [PMID: 30024414 DOI: 10.1097/dad.0000000000001218] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Despite new horizons opened by recent advances in molecular pathology, histological evaluation still remains the diagnostic gold standard regarding cutaneous melanocytic neoplasms. Several histological variants of melanoma have been described, and their knowledge is crucial for accurate diagnosis and classification of cases with unusual clinicopathological features. Uncommon histological variants of melanoma have been described based on a broad constellation of features, including architectural pattern, stromal alterations, cytological attributes, and other morphological properties. This review is aimed at providing an extensive discussion of unusual but distinctive histopathological variants of melanoma.
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Affiliation(s)
- Carlo Cota
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
- San Gallicano Dermatological Institute, Rome, Italy
| | - Andrea Saggini
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
- Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Viviana Lora
- San Gallicano Dermatological Institute, Rome, Italy
| | - Heinz Kutzner
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Arno Rütten
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Omar Sangüeza
- Department of Pathology, Wake Forest School of Medicine, Winston Salem, NC
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Lorenzo Cerroni
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
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41
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Affiliation(s)
- V Lora
- Division of Dermatology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00147, Rome, Italy
| | - E Haneke
- Dermatology Practice Dermaticum, Kaiser-Joseph-Str 262, 79098, Freiburg, Germany
| | - A Scarabello
- Dermatology Practice Dermaticum, Kaiser-Joseph-Str 262, 79098, Freiburg, Germany
| | - A Morrone
- Dermatology Practice Dermaticum, Kaiser-Joseph-Str 262, 79098, Freiburg, Germany
| | - C Cota
- Dermatology Practice Dermaticum, Kaiser-Joseph-Str 262, 79098, Freiburg, Germany
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42
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Persechino F, Franceschini C, Cota C, Frascione P, Ardigò M. A new single red nodule on the abdomen of a woman with history of endometrial carcinoma: Noninvasive evaluation and histologic correlation. JAAD Case Rep 2018; 4:941-943. [PMID: 30345339 PMCID: PMC6191948 DOI: 10.1016/j.jdcr.2018.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Flavia Persechino
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
- U.O.C. Clinical Dermatology, San Gallicano Dermatological Institute, Rome, Italy
- Department of Oncological and Preventative Dermatology, San Gallicano Dermatological Institute, Rome, Italy
| | - Chiara Franceschini
- U.O.C. Clinical Dermatology, San Gallicano Dermatological Institute, Rome, Italy
| | - Carlo Cota
- Department of Dermathopathology, San Gallicano Dermatological Institute, Rome, Italy
| | - Pasquale Frascione
- Department of Oncological and Preventative Dermatology, San Gallicano Dermatological Institute, Rome, Italy
| | - Marco Ardigò
- U.O.C. Clinical Dermatology, San Gallicano Dermatological Institute, Rome, Italy
- Correspondence to: Marco Ardigò, MD, PhD, U.O.C. Clinical Dermatology, San Gallicano Dermatological Institute, IFO, Rome, Via Elio Chianesi, 53, 00144 Rome.
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43
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Carbone A, Piemonte P, Cota C, Paolino G, Frascione P. Complete resolution and periodic recurrence of multiple postradiation atypical vascular lesions. Australas J Dermatol 2018; 60:e77-e79. [PMID: 30109893 DOI: 10.1111/ajd.12900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anna Carbone
- Oncologic and Preventative Dermatology Department, San Gallicano Dermatological Institute, Rome, Italy
| | - Paolo Piemonte
- Oncologic and Preventative Dermatology Department, San Gallicano Dermatological Institute, Rome, Italy
| | - Carlo Cota
- Dermatopathology Laboratory, San Gallicano Dermatological Institute, Rome, Italy
| | - Giovanni Paolino
- Dermatology Clinic, La Sapienza University of Rome, Rome, Italy.,Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Pasquale Frascione
- Oncologic and Preventative Dermatology Department, San Gallicano Dermatological Institute, Rome, Italy
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44
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Kovacs D, Bastonini E, Ottaviani M, Cota C, Migliano E, Dell’Anna ML, Picardo M. Vitiligo Skin: Exploring the Dermal Compartment. J Invest Dermatol 2018; 138:394-404. [DOI: 10.1016/j.jid.2017.06.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 06/21/2017] [Accepted: 06/27/2017] [Indexed: 11/28/2022]
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45
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Abstract
Rheumatoid arthritis is a chronic systemic disease that, in addition to articular involvement, may exhibit a variety of extraarticular manifestations. The skin is frequently involved mainly in the most severe forms of the disease. Rheumatoid nodules, accelerated rheumatoid nodulosis, rheumatoid nodulosis, Felty syndrome, rheumatoid vasculitis, pyoderma gangrenosum, rheumatoid neutrophilic dermatosis, interstitial granulomatous dermatitis, and palisaded neutrophilic granulomatous dermatitis are reviewed both clinically and histologically. Moreover, cutaneous reactions related to treatments of rheumatoid arthritis, in particular to biologic agents, are described. Early recognition of these entities through a clinical and histological correlation permit to optimize the management of patients.
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Affiliation(s)
- Viviana Lora
- Division of Dermatology, San Gallicano Dermatological Institute, Rome, Italy
| | - Lorenzo Cerroni
- Research Unit of Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Carlo Cota
- Unit of Dermatopathology, San Gallicano Dermatological Institute, Rome, Italy -
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46
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Lora V, De Felice C, Cota C, Graceffa D, Morrone A, Bonifati C. A case of juvenile pityriasis rubra pilaris type III successfully treated with etanercept. Dermatol Ther 2017; 31. [PMID: 29193567 DOI: 10.1111/dth.12577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/11/2017] [Accepted: 11/01/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Viviana Lora
- Department of Clinical Dermatology, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - Catia De Felice
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - Carlo Cota
- Dermatopathological Laboratory, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - Dario Graceffa
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - Aldo Morrone
- Department of Clinical Dermatology, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - Claudio Bonifati
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
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Kovacs D, Bastonini E, Ottaviani M, Cota C, Migliano E, Dell’Anna M, Picardo M. 626 Melanocyte-fibroblast interactions in vitiligo. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Muscardin LM, Paolino G, Cota C, Didona D, Panetta C, Donati P. Concurrent Sweet's Syndrome and erythema nodosum in a patient with bilio-pancreatic diversion. Ital J Dermatol Venerol 2017. [PMID: 28621118 DOI: 10.23736/s0392-0488.16.05330-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Luca M Muscardin
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Giovanni Paolino
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Carlo Cota
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Dario Didona
- Prima Divisione Dermatologica, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy -
| | - Chiara Panetta
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Pietro Donati
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
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Paolino G, Cota C, Giona F, Donati P, Lora V, Moliterni E, Santopietro M, Calvieri S, Carbone A, Zalaudek I. The different dermoscopic features of the yellow background in Langerhans and non-Langerhans cells histiocytosis. Clin Exp Dermatol 2017; 42:679-682. [PMID: 28543371 DOI: 10.1111/ced.13137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2016] [Indexed: 11/28/2022]
Affiliation(s)
- G Paolino
- Dermatological Clinic, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - C Cota
- Dermatopathological Laboratory, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - F Giona
- Department of Cellular Biotechologies and Haematology, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - P Donati
- Dermatopathological Laboratory, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - V Lora
- Clinical Department, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - E Moliterni
- Dermatological Clinic, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - M Santopietro
- Department of Cellular Biotechologies and Haematology, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - S Calvieri
- Dermatological Clinic, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - A Carbone
- Department of Oncologic Dermatology, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - I Zalaudek
- Dermatology Department, Medical University of Graz, Auenbruggerplatz, Graz, Austria
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Agozzino M, Ferrari A, Cota C, Franceschini C, Buccini P, Eibenshutz L, Ardigò M. Reflectance confocal microscopy analysis of equivocal melanocytic lesions with severe regression. Skin Res Technol 2017; 24:9-15. [PMID: 28543606 DOI: 10.1111/srt.12382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The differential diagnosis between regressing nevi and melanoma might be challenging; regressing areas can represent a confounding factor for the diagnosis and the histology still remain mandatory to rule out melanoma. Reflectance confocal microscopy may add valuable information by revealing features suggestive of the nature of the melanocytic proliferation. OBJECTIVE To assess the impact of confocal microscopy in the management of regressive melanocytic lesions. METHODS The dermoscopic analysis of 92 melanocytic lesions showing that more than 30% of regressions have been retrospectively considered, among them, 32 melanocytic lesions with a 7 check point list ≥3 they were assessed at the rcm and subsequently excised. For each selected lesion, dermoscopic features of regression (white scar-like areas, blue areas, blue white areas), distribution of regressing areas (central, peripheral, or both) and the percentage of regression have been examined by an expert in dermoscopy, blinded to the histological and confocal diagnosis. Subsequently, two experts in confocal microscopy revaluated, blinded from histology, RCM images. RESULTS Of the 32 lesions analyzed, 23 (71.5%) were diagnosed histologically as nevi, and 9 (28.5%) as melanomas. 26 of 32 lesions (81.5%) exhibited regression >50% of the overall. On RCM, 11 lesions have been interpreted as malignant and 21 as benign. On RCM the majority of nevi exhibited regular architecture without cytological atypia. Epidermal disarray, pagetoid infiltration, disarranged dermo-epidermal junction architecture and atypical nests were considered as suspicious for malignancy. Good concordance between confocal readers has been detected. CONCLUSION A combined dermoscopic/confocal approach can be used for the management of lesions exhibiting dermoscopic features of regression in order to provide a more conclusive pre-histological diagnosis avoiding a high number of unnecessary excisions. Limits of this study were represented by the relatively small number of lesions and the retrospective approach. Further, prospective studies on a larger number of cases, will be necessary in order to compare the efficacy of dermoscopy alone versus dermoscopy in combination with RCM for the evaluation of regression, suspected pigmented lesions.
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Affiliation(s)
- M Agozzino
- Dermatology Unit, Second University of Naples, Naples, Italy
| | - A Ferrari
- Department of Oncologic Dermatology, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - C Cota
- Dermatopathology Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - C Franceschini
- Dermatology Unit, University of Tor Vergata, Rome, Italy
| | - P Buccini
- Department of Oncologic Dermatology, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - L Eibenshutz
- Department of Oncologic Dermatology, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - M Ardigò
- Department of Dermatologic Clinic, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
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